Paediatric anaesthesia
-
Paediatric anaesthesia · Oct 2006
Case ReportsIliac compartment block following ilioinguinal iliohypogastric nerve block.
Transient femoral nerve palsy is a known complication associated with percutaneous ilioinguinal iliohypogastric nerve block. Excess volume and higher concentrations of local anesthetic have been implicated for transient femoral nerve palsy. We encountered partial iliac compartment block involving lateral cutaneous nerve of the thigh and femoral nerve with a lower concentration (0.25%) of bupivacaine administered in the smallest indicated volume of 0.25 ml.kg-1 using a double-shot technique.
-
Paediatric anaesthesia · Oct 2006
Recombinant activated factor VII (rFVIIa) treatment in infants with hemorrhage.
Recombinant activated factor VII (rFVIIa) is approved by the FDA for the treatment of bleeding episodes in patients with hemophilia A or B with inhibitors to factor VIII or factor IX. In addition to the FDA-approved indications, rFVIIa has been anecdotally reported effective for profound bleeding episodes in adult patients without hemophilia, and proven beneficial for adults with intracranial hemorrhage. In the pediatric literature, case reports have been made with apparent clinical improvement seen after the use of rFVIIa for acute life-threatening bleeding; however, there are limited data regarding its use in infants<4 months of age. We report our experience with rFVIIa in nine infants with severe hemorrhage of diverse etiologies. ⋯ rFVIIa is a powerful hemostatic drug whose mechanism of action provides a theoretical specificity to sites of tissue injury. In addition to its FDA-approved uses in hemophiliac patients, this drug has a potential role in the treatment of life-threatening hemorrhage from multiple causes.